卡介菌多糖核酸对慢性荨麻疹患者外周血炎症因子水平和Th1/Th2分化的影响

Effect of BCG-PSN on peripheral inflammatory cytokines and differentiation of Th1/Th2 of patients with chronic urticaria

目的探讨卡介菌多糖核酸对慢性荨麻疹患者外周血炎症因子水平和Th1/Th2分化的影响。方法以入院病例号为编号,根据随机数字表,将160例慢性荨麻疹患者随机分成两组,每组80例。对照组按照常规治疗方法,口服5 mg盐酸左西替利嗪,1次/晚;观察组同时每次肌肉注射2 ml卡介菌多糖核酸注射液,2 d一次,1个月为1个疗程。治疗1个月后观察治疗情况、复发情况,患者随访3个月,以酶联免疫吸附试验(ELISA)方法于治疗前后对患者外周血γ干扰素(IFN-γ)、IL-2(由Th1分泌)和IL-4、IL-10(由Th2分泌)进行检测。结果观察组总有效率和复发率分别为93.75%(75/80)和3.75%(3/80),均优于对照组的82.50%(66/80)和12.50%(10/80)(P<0.05);1个月后,观察组IFN-γ为(262.8±45.6)pg/ml,IL-2为(282.7±47.2)pg/ml,较治疗前提升(P<0.05),高于对照组水平(P<0.05);IL-4为(22.8±4.6)pg/ml,IL-10为(62.7±7.2)pg/ml,较治疗前水平降低(P<0.05),低于对照组水平(P<0.05);3个月时,观察组IFN-γ为(314.6±33.2)pg/ml,IL-2为(336.5±43.3)pg/ml,较1个月时水平提升(P<0.05),高于对照组(P<0.05);IL-4为(17.6±3.2)pg/ml,IL-10为(26.5±6.3)pg/ml,较1个月时水平降低(P<0.05),低于对照组水平(P<0.05)。结论卡介菌多糖核酸可有效上调外周血IFN-γ、IL-2水平,促进Th1分泌,抑制Th2分泌,下调IL-4、IL-10水平,从而维持Th1/Th2之间的平衡,降低慢性荨麻疹复发可能性。

ObjectiveTo investigate the effect of BCG-PSN on peripheral inflammatory cytokines and differentiation of Th1/Th2 of patients with chronic urticaria.Methods160 patients with chronic urticaria were randomly divided into two groups according to the random number table, 60 cases in each group. The patients in control group were treated with routine treatment, oral 5 mg hydrochloride, 1 time/night, while the patients in observation group were injected with 2 ml BCG-PSN, once every two days. After 1 month of treatment, to observe the effect of treatment and recurrence; patients were followed up for 3 months, IFN-γ, IL-2 (by Th1) and IL-4, IL-10 (by Th2) were detected by the ELISA method.ResultsThe total effective rate and recurrence rate of the observation group were 93.75% (75/80) and 3.75% (3/80), which were better than those of the control group (82.50%) and 12.50% (10/80) (P<0.05); 1 month later, the IFN-γ of observation groupwas (262.8±45.6)pg/ml and IL-2 was (282.7±47.2)pg/ml, the observation group were better than those before the treatment (P<0.05), which were superior to the control group (P<0.05); The level of IL-4 was (22.8±4.6)pg/ml and IL-10 was (62.7±7.2)pg/ml, the values were decreased (P<0.05), which was lower than those in control group (P<0.05); At 3 months, the IFN-γ of observation group was (314.6±33.2) pg/ml and IL-2 was (336.5±43.3) pg/ml, the values were more than 1 month (P<0.05), better than the control group (P<0.05); The levels of IL-4 was (17.6±3.2)pg/ml and IL-10 was&nbsp;(26.5±6.3) pg/ml, the values were decreased (P<0.05), lower than that in control group (P<0.05). ConclusionBCG-PSN can effectively increase the level of IFN-γ and IL-2 in the peripheral blood, promote the secretion of Th1, inhibit the secretion of Th2, and lower the level of IL-4 and IL-10, so as to maintain the balance between Th1/Th2 and reduce the possibility of chronic urticaria.